| NPI | 1821518655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 04752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R4321) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-05-26 |